Regulatory Adherence Analyst – Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

You’ll enjoy the flexibility to work remotely * from anywhere within the Philippines. as you take on some tough challenges. 

Primary Responsibilities:

• This individual must possess a moderate understanding of EDI Transactions, ICD and Procedure Coding. The ideal candidate will be a solid communicator, highly organized, and driven by results. The Reg Adherence Analyst plays a critical role in the Revenue Cycle Management process, managing the full life cycle of a Bulletin Alert. This includes:
  • Review/decompose Bulletins; determining if the content is meaningful and applicable to any internal audiences
  • Ensure Bulletins are processed in a timely manner
  • Ensure the proper elements tag on said Bulletins. i.e., Payer & Plan Information; Topics; Keywords; Audiences etc.
  • Ensure Bulletins are accurate and complete prior to publishing
  • Ability to identify new industry trends and communicate it to Management
  • Research & respond to Support Bulletin Research Requests
  • Ability to assist with Tracking Maintenance
  • Initiate research and resolve issues that arise or engage external teams/individuals to work with them on resolution, while keeping team apprised of issue/resolution. See Issue through to completion
  • Ability to research/build new team processes as the need arises. Offer ideas, suggestions, research to assist in development
  • Provide coverage as needed for staff PTOs/Sick Days
  • Other Duties as assigned
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Undergraduate degree or equivalent experience
• Knowledge of Medicare, Medicaid, and private insurance structures
• Ability to work independently (self-management skills)
• Reliable internet connection (minimal downtime)

Preferred Qualifications:

• Hands-on experience in medical claims processing and revenue cycle operations
• Experience with Electronic Data Interchange (EDI) in the medical insurance realm
• Skills: Experience in the following:
  • Experience with Microsoft, Excel and SharePoint applications
  • Solid working knowledge of CPT, ICD-10, HCPCS codes, modifiers, and medical terminology
  • Proven analytical and Problem-Solving Skills
  • Knowledge of HIPAA regulations
  • Understanding of payer guidelines, payer website scrubbing tools
  • Excellent verbal and written communication skills – must be able to explain complex concepts clearly and professionally
  • Highly self-motivated, accountable, and deadline-driven
  • Able to work independently and collaboratively within a fast-paced, high-volume team environment

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone – of every race, gender, sexuality, age, location and income – deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

Optum is a drug-free workplace. © 2025 Optum Global Solutions (Philippines) Inc. All rights reserved.